Jennifer Nicole Zackasee, LSW, MSW, CDCA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.2106420 Issued in OH

Practice address

11369 Market St
North Lima, OH 44452-9782

Phone

(330) 965-9999

Fax

(330) 757-0000

NPI assigned

Aug 4, 2021

Last updated

Aug 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1174297055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11369 MARKET ST",
            "city": "NORTH LIMA",
            "state": "OH",
            "postal_code": "444529782",
            "telephone_number": "330-965-9999",
            "fax_number": "330-757-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11369 MARKET ST",
            "city": "NORTH LIMA",
            "state": "OH",
            "postal_code": "444529782",
            "telephone_number": "330-965-9999",
            "fax_number": "330-757-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACKASEE",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "credential": "LSW, MSW, CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.174489",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2106420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren M Treharn, APRN
• Mallory Ann Ucchino, DO
• Chad L Volovar, MD
• Willow Nursing LLC (Willow Woods Rehabilitation and Nursing)
• Amanda Winkler, LISW

• Clinical Social Worker in North Lima, OH
• Providers in North Lima, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.